Meta-analysis of resting-state fMRI shows brain activity alterations in social anxiety disorder compared to healthy controls

INTRODUCTION: Social anxiety disorder (SAD) is a commonly occurring mental health condition characterized by excessive fear and anxiety in social situations. The disorder significantly impacts individuals' daily functioning and is often associated with a range of emotional and physiological symptoms. Understanding the neural basis of SAD is crucial for developing effective treatments. METHODS: This meta-analysis utilized anisotropic effect-size seed-based d mapping with permutation of subject images (SDM-PSI) to examine brain activity alterations in SAD patients. We systematically reviewed neuroimaging studies, focusing on resting-state functional magnetic resonance imaging (fMRI) data, and analyzed the reported regional brain activity alterations. Our search encompassed studies published up to July 31, 2024, and applied strict inclusion and exclusion criteria to ensure the reliability of the findings. RESULTS: The analysis revealed increased functional activity in the left superior parietal gyrus, right cerebellum, and right supramarginal gyrus, along with decreased activity in the left insula and right supplementary motor area in SAD patients compared to healthy controls (HC). Meta-regression analysis indicated a negative correlation between left insula activity and age, and between right supplementary motor area activity and symptom severity. CONCLUSION: The findings provide evidence for distinct neural signatures in SAD, emphasizing the pivotal role of key brain regions in the disorder's pathophysiology. These results contribute to the understanding of the neural correlates of SAD and may guide the development of therapeutic strategies in the future.